A 45-year-old presents with epiphora and a medial canthal swelling that regurgitates mucopurulent material on pressure (Anel test: syringe pressure regurgitation from lower punctum). DCR (dacryocystorhinostomy) is planned. Which anatomical structure forms the anterior lacrimal crest that is used as a landmark during DCR?
- A Lacrimal bone
- B Nasal bone
- C Frontal process of the maxilla ✓
- D Ethmoid bone
Correct answer: C. Frontal process of the maxilla
Explanation
The lacrimal sac fossa is bounded anteriorly by the anterior lacrimal crest of the frontal process of the maxillary bone, and posteriorly by the posterior lacrimal crest of the lacrimal bone. During DCR, the anterior lacrimal crest (maxilla) is the key surgical landmark — the lacrimal sac is located just posterior to it. Osteotomy is made through the lacrimal bone (thin, posterior wall) and maxilla to create a rhinostomy into the nasal cavity.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.